Bender, J. L., Yue, R. Y., To, M. J., Deacken, L., & Jadad, A. R. (2013). A lot of action, but not in the right direction: Systematic review and content analysis of smartphone applications for the prevention, detection, and management of cancer. Journal of Medical Internet Research, 15(12), e287. doi:10.2196/jmir.2661
As of 2011, more than 6 billion active cell-phone subscription, accounting for 87% of the global population
2012 - 85% of Americans own a cellphone, 53% of which are smartphones. Not much is known re: efficacy of health programs that use smartphones (i.e. apps) vs. regular cellphones
5 General strategies for health apps (Klasjna and Pratt, 2012): (1) tracking health information (eg, through text messaging, native apps, or automated sensing), (2) involving the health care team (eg, remote coaching, symptom monitoring), (3) leveraging social influence (eg, peer-to-peer support, modeling, or influence), (4) increasing the accessibility of health information (eg, short messages or reminders), and (5) utilizing entertainment (eg, games to motivate health management).
Estimated to be about 28 million cancer survivors worldwide - many experience ongoing long-term consequences of disease, and seek information online
Researchers searched iPhone App store, Google Play, BlackBerry App World, Nokia/Symbian for cancer apps. 309 apps fit selection criteria, of which 12 were available in more than one platform - 295 unique apps
Half of apps (148) were free - 8 of those were trial versions of full apps. Rest ranged from CAD $1 to $12 (median $1.01)
The majority of the apps did not describe their organizational affiliation (64.1%, 189/295)
Of those that provided organizational information, 63.2% (67/106) were affiliated with a non-profit, 26.4% (28/106) with a commercial company (eg, Health Monitor Network), 9.4% (10/106) with a university or medical institution, and 1 app was affiliated with a government institution (eg, National Institutes for Health).
Free apps were more likely to be affiliated with not-for-profit, where apps with a price were more likely to not disclose affiliation.
Most apps (95) aimed at raising awareness or providing information about cancer. 38 promoted fundraising, 30 promoted charitable organization. 6 were aimed at cancer prevention, 34 at early detection, 11 at management. Only 3 allowed for users to communicate with other survivors.
No app reported an evaluation of any form in their store description.
Most apps did not take full advantage of smartphone capabilities - of those that had a disease prevention/management function, most were for tracking/journaling. A few melanoma tracking apps allowed for photoing lesions. No apps used sensor tracking. This could be due to FDA restrictions on medical devices - e.g. an app that collected vital signs would need to pass regulations as a medical device
Only a few apps allowed for interaction with health professionals - could be due to health professionals not being involved in app development
Other studies have found that apps targeted toward healthcare professionals are much more likely to have scientifically valid information than apps developed for general public (96% vs. 32%).
Overall, a real lack of efficacy data or regulation - for example, 4 melanoma apps that use pictures and apply risk algorithms were reviewed (and should be FDA regulated) - 3 of them incorrectly classified 30% or more of lesions as “unconcerning”.
Bender, J. L., Yue, R. Y., To, M. J., Deacken, L., & Jadad, A. R. (2013). A lot of action, but not in the right direction: Systematic review and content analysis of smartphone applications for the prevention, detection, and management of cancer. Journal of Medical Internet Research, 15(12), e287. doi:10.2196/jmir.2661